When doctors have a simulated operating room

Wait!

What is this? ? !

Zhang Yi's eyes were attracted by Zhao Xiaolong's abdomen.

I saw that his left kidney had become red and swollen at some point.

And there was cystic effusion in the glomerular sac? !

Damn!

It's renal failure!

Why didn't this happen in the clinic just now?

Did it start after entering the emergency room?

Or after using the rescue medicine?

It was only a dozen minutes in total, how could the change be so fast?

And the cyst in the sac looked a bit strange!

For a while, many speculations and ideas popped up in Zhang Yi's mind.

Severe myocarditis patients will indeed suffer from renal failure if delayed to the later stage.

If it has really reached such a serious stage...

Even Hua Tuo can't save him.

Fulminant myocarditis, especially caused by viral infection, once it develops into multiple organ failure, it is really just waiting for death.

Zhang Yi couldn't help but sigh and looked at the patient on the bed.

If this is true, then he can't do anything.

Do your best and leave it to fate.

Zhang Yi continued with a bit of dejection: "I have asked Xiao Li to call the family members, don't worry."

Kang Yanming nodded: "That's good, it's hard to say about this person, the next rescue work will be handed over to you. Let's go, except for Zhang Yi's two apprentices, the rest of you will continue to make rounds with me."

After that, Kang Yanming led people out of the rescue room.

Li Mingliang and Li Pingping stood obediently by the side, looked at Zhang Yi's heavy expression, and said carefully: "Master, do you need... our help?"

The rescue just now failed, and the ultrasound doctor is re-examining the patient.

There were two other doctors in the emergency room waiting for the results of the examination by the bed.

Zhang Yi frowned and sighed, "Not for now."

"Then... is this person dying? I know that this kind of explosive myocarditis has a very rapid onset, and sometimes it is too late to rescue. Master, don't be too sad..."

Zhang Yi turned his head and glanced at Li Pingping: "I am sad? Who told you that I was sad?"

"I... I saw that you seemed a little unhappy, so I thought you were sad."

"It's okay, I'm not sad, I just feel sorry. This person is probably in the stage of exhaustion now. A life just disappeared from my hands... Alas!"

Zhang Yi sighed like this, and several people around him shut up.

The atmosphere became heavy for a while.

To put it bluntly.

It's really common for people to die in hospitals.

Where else can they die if they don't die in the hospital?

It's just that watching a life disappear like this under my nose, I still feel very heavy.

Then, Zhang Yi picked up the stack of checklists again and started to look through them.

Zhang Yi already knew the results of the ultrasound in advance.

But the problem now was the cyst in the left kidney.

Zhang Yi took another look and found that the right kidney was still fine.

Only the left kidney had a problem.

The fluid in the left kidney cyst was a little reddish, and the color and texture were a little different from those of other failing kidneys.

Strange.

Was the failure really caused by myocarditis?

This question suddenly popped up in Zhang Yi's mind.

But if it wasn't myocarditis, why did all the test indicators meet the standards of myocarditis?

The next second, something seemed to flash through Zhang Yi's mind!

"No, no!"

Zhang Yi suddenly said.

Several doctors nearby were startled: "What's wrong, Dr. Zhang? What's wrong?"

Zhang Yi stared at the stack of checklists in his hand and didn't answer.

White blood cells...

Lymphocytes...

B-type natriuretic peptide...

Creatinine...

Urea nitrogen...

D-dimer...

Zhang Yi held the test sheets in his hand, and the numbers with clear indicators passed by his eyes!

They seemed to help doctors find the cause of the disease.

But in fact, it was just a foggy trick.

A qualified doctor must find the most critical evidence among the dazzling results!

Hmm? ! ?

Wait!

It seems that a very important link is missing!

If the patient's myocarditis leads to renal failure, then this person's myocarditis must be viral myocarditis.

But the test results show:

White blood cells 17.9 (4.0-10.0) × 10^9 / L);

Lymphocyte 0.9! (1.1-3.210^9/L)!

If it is a viral infection, lymphocytes will definitely rise, but this person's lymphocytes not only did not rise but also decreased a little?

And white blood cells, according to the infection, this person's white blood cell rise is not too high.

Some severely infected white blood cells can even soar to 100×10^9/L!

So...

The cause of this person's illness may not really be myocarditis!

But if it is not myocarditis, then what is it?

Myocardial infarction?

Thinking about it, Zhang Yi once again focused on the patient.

At this time, the books he had read, the information he had checked, and the cases he had studied flashed through his mind like a revolving lantern.

Heart failure...

Kidney cyst...

Kidney? ! ?

Yes! !

The cause is kidney!

And these symptoms are not myocarditis!

This can confuse the doctor's eyes and make the doctor misdiagnose.

Acute upper abdominal pain with shock, heart failure, widespread ST-segment elevation, only believe in healthy walking, significantly elevated myocardial injury standards, acidosis, circulatory disorders, elevated white blood cells and high-sensitivity C-reactive protein do not match, significantly elevated D-polymers, renal failure... etc.!

These series of case characteristics are combined to have only one explanation: pheochromocytoma!

Pheochromocytoma is a rare disease, but it is a benign tumor.

Early detection and early treatment, as long as the tumor is cut off with one knife, the patient's chance of survival is very high.

But the problem lies here.

This pheochromocytoma is very good at "acting".

Its acting skills are very superb, so high that many doctors can misjudge, even Zhang Yi was deceived by it.

It can show many symptoms.

For example, high blood pressure and low blood pressure, these two symptoms alone can make many doctors deviate from the direction of diagnosis.

There are also shock, heart failure, malignant arrhythmia, myocardial infarction, etc.!

Let's just talk about hypertension. For example, a patient with hypertension comes to the outpatient clinic. Nowadays, patients with hypertension are very common, and most of them are caused by eating.

Some careless doctors may just prescribe antihypertensive drugs to the patient and that's it.

Who would have thought that the cause of the disease is such a rare pheochromocytoma? ?

So why can it have so many changes?

The reason is that this pheochromocytoma releases a large amount of catecholamines.

This catecholamine is a neurological substance that can cause smooth muscle spasm, so the patient will have abdominal pain!

It can also cause myocardial damage, resulting in inferior wall ST segment elevation and a significant increase in troponin. The patient not only has abdominal pain, but also gives the doctor a very obvious misdiagnosis of myocardial infarction or myocarditis.